This is important to me as I treasure both my medical practice and our community, connection, exchanges on-line. I don’t want to do anything that jeopardizes either, nor the implication that if I did, that means I would have mistreated a patient.

Thank you for this, what I call, a “good problem” to have – the joy of medical practice and participation in social media/networking.

So many of you resonated with this and engaged. I am still super grateful. I’d love to continue with you in further discussion and with your comments!

For me, one of the many reasons I was so excited about this recent talk at the APA is because of the mucho online stuff connected to my name that affects my patients and the dynamics in our patient-doctor relationship.

In my practice, these are just a few sites that have wrong information (demographics) on me:

healthgrades.com

vitals.com

betterdoctor.com

ucomparehealthcare.com

insiderpages.com

They didn’t ask to clarify my demographics. They didn’t ask me if I wanted them to become an on-line reference on my behalf. They use my practice information to drive “eye-balls” to their site so they can get advertizing money and more. They impose incorrect information about my practice, knowing that in so doing, I will be pressed, (I call it bullied,) into contacting them with my correct information.

If I don’t do this expensive effort, (money, time, emotional expense – all in limited supply, to correct what they post incorrectly,) patients will continue to tell me that they couldn’t find my contact information. When they Google me, instead of my website coming up, these other sham pages pop up.

Some patients call dead numbers or even drive to incorrect locations to find treatment. Instead of whomever is behind these websites being held responsible, the medical providers are.

These are the notes I took from my colleagues, as I heard them say.

Unfortunately, I was late to the meeting so I missed two of the four speakers. Even so, this is worth it.

Every practitioner has an idea that they are a pretty good doctor. So it isn’t easy for any of us to hear otherwise ;). After getting unsolicited feedback from a person who took the time to write a comment on a site that listed her, a site that listed her profile without asking her, Dr. Miller chose not to play the victim. She decided to call “Health Grades,” and with her persistence, they took her information down.

On “Vitals” – she got an answering machine with a person’s voice mail and no name and number. So she called CEO, Mitch, who stated she wasn’t able to take her profile down. She didn’t ask to open herself up to trolls.

Dr. Miller asks, what shall we do, as physicians?

do nothing

write a response

try to call the company

There are many whose livelihoods depend on public opinion. For example, waitresses/waiters – many lose their jobs if they get even one negative reviews.

The practitioners in the group responded with resonance with Dr. Miller’s ideas. They also had thoughts that if left alone, the democratic process would win out over time, truth would come out and such. (Maybe the nearby statue of Liberty played into our thoughts :).)

Contact the patient who wrote a negative response to request removal – Patient not likely to remove response, many patients post anonymously, most websites won’t allow patients to remove them

Flood site with fake positive reviews – deceptive, embarrassing if discovered, ? inducing a person to rely on a statement that may be used to their detriment (fraud)

sue patient for libel – identify patient might be difficulty, people have a right to their opinions – would have to prove statements untruthful and not merely opinion, $$ in money/time/and emotion

Encourage Satisfied Patients to Post Reviews? We could refer to a firm to do this. $$

Some sites, similar to “Vitals” offer the option to the practitioner to respond to a posted review.

Negative Reviews:

If we do respond – how? We don’t want to come across arrogant or insulting. We fear violating patient-doctor confidentiality. In the end, we recognize we don’t have the last word. We may respond with a soft word of concern. “If you would call my office, I’d be happy to schedule at no fee to speak with you about this and see if I can help.”

Another idea is that medical practitioners help themselves by coming together to develop an internet ombudsman. This would be a medical/mental health professional not involved in care of patient.

Independent (unrelated party) investigation of physician about the case. A successful investigation may give a third party opinion. There’d have to be a reason for the world to trust this opinion.

It is difficult for healthcare professionals to protect themselves from inaccurate complaints about their care.

Positive Reviews

Does it put undue pressure on the patients?

A sign in waiting room perhaps. Make the information available w/o practitioner knowing if they have or have not commented.

There is a dissonance between the position of being a business person that says we must practice democratically and compete fiscally, yet stay in congruence with what tradition holds us to.

The issues addressed in the talk weren’t specifically about being bullied by sham-websites, but it included that idea, along with other difficulties physicians are experiencing in the rapid transition of 3000 years of tradition as a healthcare providers to spending the majority of their time serving patients first to now, the reckless $ burden of running a media vulnerable business.

In the practice of psychiatry, a traditionally extreme-private practice, this is dissonant to many.

Q: How do we treat the extremely delicate practice of psychiatry as a business when we are held to currently minimally defended standards like this? Please speak out and let it flow! We need to hear from you! …and, Keep on.

Self-Care Tip: Deal with internet sham-sites and reviews in a method that is consistent with Me, and temperament, while doing the least damage to oneself. It will be better for oneself as well as others.

When someone is doing something to turn us into an emotional victim, sometimes it can look like a performance, don’t you think? Someone is yelling, arms swinging about, face animated – and there you are, breathless and emotional.

However, being victimized and being a victim are different things. Being a participant of an interpersonal exchange is different from being an audience to it.

Imagine a stage and you and have been selected from the audience. You climb up and join the performer, let’s call him Ron. Ron is a professional fire and knife dancer. You are standing near Ron and flaming knives seem like they are everywhere. He is quite a dramatic dancer and part of you wants to dance with him. You know you would get hurt badly and yet you have the hardest time resisting the urge to participate. Your wisdom prevails and you remain uninjured. You applaud and walk away.

Later at home, you are still marveling that anyone could move that way and work that hard to evoke such strong emotion from their audience. The emotions replay the dance in your mind almost as if you were still there with Ron.

When you don’t like what someone is doing or saying to you, imagine that it is a performance of sorts and don’t take it personally. You don’t have to be a victim. You have the power. Be a friend to yourself.

Now, if you can’t do this no matter what, if you feel powerless and unresponsive to your redirections, it may be medical. You might be suffering from any number of illnesses that cause personalization, guilt, fear, reliving experiences and so forth. You shouldn’t suffer like that. You were created to feel pleasure.